Statement of Health

New hires are allowed to enroll in supplemental life insurance up to $250,000* for yourself and up to $20,000 for your spouse or same-sex domestic partner without providing a Statement of Health form.

Increases in coverage during Open Enrollment or due to a qualifying family status change require a Statement of Health, however, this form is not required when electing spouse or same-sex domestic partner coverage levels of $10,000 or $20,000.

All completed Statement of Health forms should be submitted directly to MetLife. Completed forms can either be faxed, mailed, or emailed to MetLife.

Metropolitan Life Insurance Company

Statement of Health Unit

P.O. Box 14069

Lexington, KY 40512-4069

FAX: 1-859-225-7909


Should you have any questions, or require accommodations to access any information on this webpage, please reach out to HR Shared Services at 315.443.4042.

*Part-time faculty eligible for Modified Benefits will need to complete a Statement of Health form for any amount elected over $20,000.

Helpful Links

Every effort has been made to ensure that the information contained within this website is accurate. However, benefits are governed by legal documents (which, in certain circumstances, may include insurance contracts). If there is any difference between the information in this website and the official documents, the official documents will control. As is the case with all of Syracuse University’s employee benefit plans, the University reserves the right to modify or terminate these benefits at any time.